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Ministry: Lack of internal medicine beds, home care, reduces elderly hospital days
By JUDY SIEGEL-ITZKOVICH
09/03/2014
Internal medicine wards are usually populated by the elderly, as they suffer from more complex chronic conditions.
 
Despite the aging and growth of the Israeli population, the number of days that patients were hospitalized in internal medicine units has declined since 2000. The reasons are both positive and negative – more are treated by their health funds in the community and there are too few internal medicine beds in medical centers, forcing medical centers to send some patients home prematurely.

This was reported in a 57-page report on “Hospitalization in Internal Medicine Departments” issued by the Health Ministry on Sunday.

Internal medicine wards are usually populated by the elderly, as they suffer from more complex chronic conditions and need special care by medical teams with multidisciplinary skills in the malfunction of internal organs.

In 2012, according to the report, there were 284,300 hospitalizations in the general hospitals. Two-third of patients in internal medicine departments were 65 years old or older, while 42 percent were over 75 and 17% over 85.

The older the patients were, the more likely they were to need this care. At age 85 and over, the rate was nine times higher and between 75 and 84 the age was five times higher than the general rate of hospitalization. The average stay in an internal medicine department was 4.7 days in 2012.

In 2012, one-fifth of all the patients were readmitted within a month and 8% within only a week after being discharged from internal medicine departments.

This is a sign that many patients were sent home prematurely because they were not fully treated due to the lack of beds, and when their conditions worsened at home, they had to be readmitted.

In 2011, according to the report, 42% of internal medicine department patients who were there for at least two days and discharged returned at least once within a year; 32% returned at least once in six months; 14% were readmitted once within a month; and 6% returned at least once in a week.

In general, men were 1.1 times more likely to be readmitted than women, and married people were 0.9 times less likely to be readmitted – an indication that wives take better care of their husbands when they are ill.

Arabs, however, were 1.05 times more likely to need readmission than Jews and other populations born in Israel, a possible sign that they had less access to the hospital care they needed or were less aware of their rights to care.

Prof. Arnon Afek, head of health administration at the ministry, told The Jerusalem Post that indeed, readmission is not a good thing, but “it happens all over the world. If patients stay in hospitals longer, they are likely to leave when they have recovered more. To deal with the problem of too-few internal medicine beds, you have to strengthen the continuity between the hospital care and the health funds’ care in the community clinics,” he said.

“We are doing this, as we recently instituted an electronic system in which hospitals report to the health funds on patients they treated and what follow up care they need in the community.”

Afek conceded that there are too few internal medicine beds, especially intensive care beds, in the hospitals.

But new internal medicine departments have been opened or reopened in five hospitals around the country, and in 2016, it is expected that there will be almost 1,000 such beds available.
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